Simply put, long-standing hip and groin pain (LHGP) is discomfort in the hip and groin region lasting six weeks or longer that often limits physical function and reduces quality of life. For some patients, simple activities like walking, climbing stairs, and sitting for prolonged periods of time can feel impossible. Unfortunately, LHGP tends to come on gradually over time and has no easily identifiable cause, which can make diagnosis (and treatment) a challenge.
Part of the difficulty in diagnosing LHGP is to determine if the patient’s symptoms are caused by a primary disorder of the hip and/or groin area or if it is referred from a nearby part of the body that may need to be addressed. Potentially, the patient’s hip pain can be a secondary injury related to a problem elsewhere in the kinetic chain. For example, dysfunction in the lower back, knees, ankles, and feet can all alter the biomechanics of the hip, increasing the risk for injury. If such issues co-occur with hip pain, they’ll likely need to be resolved as well (hopefully with conservative chiropractic care).
Then there’s the complexity of the hip joint itself and the various problems that can affect it. These include osteoarthritis, labral tears, hip dysplasia, and sports hernias. Ultimately, diagnosis will be based on a review of the patient’s history, examination findings, and possibly diagnostic imaging.
The most common underlying causes of LHGP are femoroacetabular impingement syndrome (FAIS), chondral (cartilage) lesions, and labral lesions. Individuals whose everyday activities include extensive movement of the hip joint—such as soccer or hockey players—are at increased risk for LGHP, often due to repetitive stress and acute injuries. Older and sedentary adults are also at risk for LGHP, though the cause will more often be linked to degenerative conditions like osteoarthritis.
Because the underlying cause of LHGP can vary, the treatment approach used for each patient will be tailored to their unique case. The multimodal approach used by a doctor of chiropractic may include long-axis distraction, mobilization, and thrust manipulation delivered in the office with two to three treatments a week for six weeks being a common initial approach. Physiotherapy modalities and at-home stretches/exercises may also be utilized with the goal of improving strength and flexibility. Less physically active patients may also receive advice on how to incorporate more movement into their day-to-day routine to help prevent recurrence.
